Provider Demographics
NPI:1124695903
Name:DOCKINS, COREY ALLAN
Entity type:Individual
Prefix:
First Name:COREY
Middle Name:ALLAN
Last Name:DOCKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1920 BRIDGEWATER DR
Mailing Address - Street 2:
Mailing Address - City:CLARKSVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37042-4558
Mailing Address - Country:US
Mailing Address - Phone:580-458-9466
Mailing Address - Fax:
Practice Address - Street 1:118 UNION ST
Practice Address - Street 2:
Practice Address - City:CLARKSVILLE
Practice Address - State:TN
Practice Address - Zip Code:37040-5115
Practice Address - Country:US
Practice Address - Phone:931-534-8339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-06-09
Last Update Date:2021-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor